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引用次数: 0
摘要
背景:同基因突变,即两个完全相同的基因版本(等位基因),来自每个亲生父母,是一种特殊情况。受影响家庭的临床描述仅由少数携带者组成,散见于各种文献中,阻碍了证据的产生:方法:文献分析包括 5 个 RET 家族,每个家族有≥1 个同源基因携带者和≥3 个杂合基因携带者:在有一级堂兄弟姐妹的近亲家庭中,同基因携带者在十几岁时出现结节阳性甲状腺髓样癌和嗜铬细胞瘤,而杂合子则在三十岁末和四十岁初发病。同卵双生者比异卵双生者患结节阳性甲状腺髓样癌早27.4年,患嗜铬细胞瘤早23年。在15个携带p.Leu666delinsAsnSer创始突变的家族中,这些年龄差异较小,其中同卵双生者在40多岁时就患上了结节阳性甲状腺髓样癌,比杂合子在50多岁时早6年:这些结果的范围和规模有限,并受近亲程度的影响,但与加速 MEN2A 发病的中等剂量反应效应一致。
Accelerated MEN2A in homozygous RET carriers in the context of consanguinity.
Background: Homozygous mutations, 2 identical gene versions (alleles), 1 from each biological parent, are exceptional. Clinical descriptions of affected families, comprising few carriers only, are scattered throughout the literature, hindering evidence generation.
Methods: Included in this literature analysis were 5 RET families with ≥1 homozygous carrier and ≥3 heterozygous carriers per family.
Results: In consanguineous families with first-degree cousins, homozygotes presented with node-positive medullary thyroid cancer and pheochromocytoma in their mid-teens, whereas heterozygotes presented in their end-30s and early 40s. Homozygotes developed node-positive medullary thyroid cancer 27.4 years and pheochromocytoma 23 years earlier than heterozygotes. These age differences were smaller in the 15 families carrying founder mutation p.Leu666delinsAsnSer, whereas homozygotes developed node-positive medullary thyroid cancer in their mid-40s, 6 years earlier than heterozygotes in their early 50s.
Conclusion: These results, limited in scope and size and modulated by extent of consanguinity, are consistent with moderate dose-response effects accelerating MEN2A development.
期刊介绍:
European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica.
The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology.
Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials.
Equal consideration is given to all manuscripts in English from any country.